Neuropsychological disturbances and cerebral blood flow in bipolar disorder
Neuropsychological disturbances and cerebral blood flow in bipolar disorder
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DOI：
10.1111/j.1440-1614.2004.01558.x
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发表时间：
2005-04-01
影响因子：
4.6
通讯作者：
Valdés, M
中科院分区：
文献类型：
--
作者：
Benabarre, A;Vieta, E;Valdés, M
目的：确定双相情感障碍患者的神经心理功能和脑血流的改变并将其关联起来。评估包括阳性和阴性症状量表、整体评估功能、韦氏成人智力量表（WAIS）、威斯康星州卡片分类测验（WCST）、Stroop测验、连线测验（TMT）、加州言语学习测验（CVLT）、Wechsler记忆量表（WMS）和语音语言流畅性/受控口头单词联想测试。用99 mTc-HMPAO进行单光子发射计算机断层扫描（SPECT）。85名符合RDC双相情感障碍诊断标准的门诊患者中有43名患者和6名健康受试者被纳入研究。对30例躁狂（n = 7）、轻躁狂（n = 8）、抑郁（n = 12）和正常心境（n = 3）患者进行SPECT和神经心理学评估。结果：神经心理功能与脑血流量（CBF）之间存在校正的相关关系：执行功能（WCST）与纹状体、额叶、颞叶、小脑、顶叶和扣带回CBF之间的相关关系;记忆功能（WCST）与纹状体、额叶、颞叶、小脑和扣带回CBF之间的相关关系;注意任务（Stroop）与纹状体、颞中、顶叶CBF;言语学习（CVLT）和额叶、后颞叶、扣带回和枕叶CBF;精神障碍（TMT）和前颞叶CBF;智力表现评分（WAIS-Vocabulary）较差以及小脑和顶叶CBF。结论：本研究证实了双相情感障碍患者存在额皮质下结构、小脑和边缘系统的功能障碍。
Objective: To determine and correlate alterations in neuropsychological function and cerebral blood flow in bipolar patients.Method: Assessments included the Positive and Negative Symptom Scale, Global Assessment Functioning, Wechsler Adult Intelligence Scale (WAIS), Wisconsin Card Sorting Test (WCST), Stroop test, Trail Making Test (TMT), California Verbal Learning Test (CVLT), Wechsler Memory Scale (WMS) and phonetic verbal fluency/controlled oral word association tests. Single photon emission computed tomography (SPECT) was carried out with the administration of 99mTc-HMPAO. Forty-three outpatients out of 85 fulfilling RDC diagnostic criteria for bipolar disorder and six healthy subjects were included in the study. SPECT and neuropsychological assessments were performed in 30 patients in manic (n = 7), hypomanic (n = 8), depressed (n = 12) or euthymic (n = 3) states. All assessments were carried out before starting treatment.Result: Several corrected correlations between neuropsychological function and cerebral blood flow (CBF) were identified: executive function (WCST) and striatal, frontal, temporal, cerebellum, parietal and cingulate CBF; memory (WMS, WAIS-Digits) and striatal, frontal, temporal and parietal CBF; attentional tasks (Stroop) and striatal, temporo-medial and parietal CBF; verbal learning (CVLT) and frontal, posterior temporal, cingulate and occipital CBF; psychomotor disturbances (TMT) and anterior temporal CBF; poorer intelligence performance scores (WAIS-Vocabulary) and cerebellum and parietal CBF.Conclusions: This study confirms the presence of functional disturbances in fronto-subcortical structures, the cerebellum and limbic system in bipolar patients.